Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Dab (Limanda limanda) Age Reading Exchange 2019

The goals of the 2019 dab exchange were (1) an estimation of ageing uncertainty for the dab.27.3a4 stock, (2) compare different preparation methods, and (3) examine seasonality in deposition of opaque/translucent material on the edge of the otolith across a latitudinal gradient. The second and third goals were follow-up actions proposed by the Workshop on Age Reading of Dab in 2015 (WKARDAB2). Sixteen age readers from seven countries (Belgium, France, Iceland, Netherlands, Germany, Denmark, England) participated in the exchange. Two sets of otoliths were examined. The first set (SmartDots event 244) consisted of 64 otoliths from ICES Subarea 4 (North Sea) and Division 3a (Skagerrak and Kattegat). These were prepared in three different manners (whole, sectioned, and sectioned-and-stained), resulting in 192 images. The second set (SmartDots event 245) consisted of 68 otoliths from ICES Subarea 4 (North Sea) and Division 5a (Icelandic waters). These were prepared in two different manners (whole and sectioned-and-stained), resulting in 136 images. Age readers were also asked to determine the edge type for each otolith in the second set. First, the data were analysed for each event and method separately, including all age readers. Then, the combined set of otoliths from Subarea 4 and Division 3a were analysed for each method separately, including only the advanced age readers who supply age data for the assessment of the dab.27.3a4 stock. Additional analyses were carried out to compare the different preparation methods, and to examine seasonality by area in the deposition of opaque/translucent material. Age reading uncertainty was high in dab compared to most other North Sea flatfish species. The percentage agreement was 69-73% and the coefficient of variation was 13-14% for dab.27.3a4, based on the age determinations of readers who supply age data for the assessment. As observed previously, uncertainty was highest in the third quarter. Comparison of methods showed better calibration results for sectioned-and-stained otoliths than for whole otoliths or sectioned otoliths. However, the ages of young fish (1-6) were on average estimated to be higher based on sectioned-and-stained otoliths than based on whole otoliths. Age reading certainty may improve if sectioned-and-stained otoliths are used by all readers, preferably after validation that this is the best method to estimate true age. The edge analysis was hampered by low number of otoliths per month and area, and inconsistency between readers. Nevertheless, the analysis did show high variability in the timing of deposition of opaque/translucent material. Consequently, a fixed rule on how to interpret the edge of the otolith in the third quarter is not applicable for dab

Law and Narrative: A Bibliography of Recent Work

This bibliography collects work focused specifically on law and narrative, published (approximately) over the last four years (i.e., 2013-17). A significant amount of work touches on narrative, without taking that as its focus; this work will be included in a bibliography of recent work on law and literature more generally (now being compiled)

Discovery of a Potent and Selective ROMK Inhibitor with Pharmacokinetic Properties Suitable for Preclinical Evaluation

A new subseries of ROMK inhibitors exemplified by <b>28</b> has been developed from the initial screening hit <b>1</b>. The excellent selectivity for ROMK inhibition over related ion channels and pharmacokinetic properties across preclinical species support further preclinical evaluation of <b>28</b> as a new mechanism diuretic. Robust pharmacodynamic effects in both SD rats and dogs have been demonstrated